RESUMEN
We report on an 80-yr-old patient with a history of inferior myocardial infarction. The patient was injected with 15 mCi of 99mTc-sestamibi when an electrocardiogram revealed new asymptomatic inferolateral ST-segment depressions. A second 99mTc study was performed 72 hr after the initial injection and after ST-segment changes had resolved. Scintigraphic acquisitions using SPECT revealed a large reduction in photon activity in the inferolateral and inferoposterior walls with 70%-80% normalization. Therefore, 99mTc-sestamibi imaging is useful in assessing asymptomatic silent myocardial ischemia.
Asunto(s)
Corazón/diagnóstico por imagen , Isquemia Miocárdica/diagnóstico por imagen , Tecnecio Tc 99m Sestamibi , Anciano , Anciano de 80 o más Años , Electrocardiografía , Femenino , Humanos , Infarto del Miocardio/complicaciones , Isquemia Miocárdica/complicaciones , Isquemia Miocárdica/fisiopatología , CintigrafíaRESUMEN
Four cases of papillary muscle rupture occurring in the setting of acute myocardial infarction are presented, which illustrate the following points: the diagnosis may not be apparent at presentation, a mitral regurgitant murmur may be absent, transesophageal echocardiography may establish the diagnosis when transthoracic echocardiography does not, and appropriate surgical correction can lead to excellent functional recovery.